Status of imported malaria in a control zone of the United Arab Emirates bordering an area of unstable malaria
Dar, F.K.; Bayoumi, R.; al Karmi, T.; Shalabi, A.; Beidas, F.; Hussein, M.M.
Transactions of the Royal Society of Tropical Medicine and Hygiene 87(6): 617-619
1993
ISSN/ISBN: 0035-9203 PMID: 8296356 DOI: 10.1016/0035-9203(93)90261-nDocument Number: 338084
In Al Ain District located in the Abu Dhabi Emirate of the United Arab Emirates (UAE), clinicians at the Al Ain General Hospital outpatient clinic conduct a medical examination of and take blood samples from all new immigrants applying for resident or work permits. All persons with malaria receive 600 mg chloroquine phosphate at the clinic (day 0) and a prescription for another 600 mg for day 1 and 300 mg on day 2. The malaria cases are to return to the clinic on day 3. Entomologists record mosquito larval counts at all field sides and conduct susceptibility tests in the laboratory. The malaria control program applies a larvicide on breeding sites and uses pyrethroids to eliminate adult flying insects. In 1981, local transmission of malaria ceased. During 1988-1991, 4.7-9.1% of the population was slide-positive for malaria. This incidence rate is high enough to introduce imported malaria into the local anopheline mosquito population, should malaria control activities be reduced. Pakistanis, UAE nationals, and Omanis comprise most malaria cases (36.3-56.6%, 12.8-21.9%, and 15.7-25.3%, respectively). The immigrants tend to visit their home countries, where they acquire malaria. All UAE nationals acquire it while on holiday in or traveling to endemic areas, especially Oman. In 1991, out of 1150 cases, the leading sources of malaria were clearly Pakistan (576) and Oman (526). Most slide-positive children are either Omanis or part of UAE families with relatives across the border in Oman. Plasmodium falciparum, mostly from Pakistan and Oman, is responsible for 69.5% of malaria cases. The Indian subcontinent is the source of most P. vivax cases. Beginning in 1987, the number of chloroquine-resistant P. falciparum cases increased from 9 to 302. The leading sources of resistant cases originate from Oman (160), Pakistan (100), and Sudan (26). All chloroquine-resistant cases except one responded to Fansidar. Factors that may disturb effective malaria control efforts in this new agriculture area are rapid development of water resources and the undemarcated border with Oman.
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